Individual
MRS. MINDY SHAFER WEIGEL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
560 PATHWAY CLINIC, PRAIRIE DU SAC, WI 53583
(608) 643-3663
Mailing address
560 PATHWAY CLINIC, PRAIRIE DU SAC, WI 53583
(608) 643-3663
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
4170
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39795400
—
WI
Enumeration date
05/25/2006
Last updated
07/08/2007
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